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acute kidney injury sepsis

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https://www.readbyqxmd.com/read/28821165/mirna-21-has-effects-to-protect-kidney-injury-induced-by-sepsis
#1
Dian Fu, Jie Dong, Ping Li, Chaopeng Tang, Wen Cheng, Zhenyu Xu, Wenquan Zhou, Jingping Ge, Chen Xia, Zhengyu Zhang
To investigate the miRNA-21 over-expression in the acute kidney injury induced by sepsis, we developed a sepsis induced in vitro model by lip polysaccharide (LPS) and in vovo model by cecal ligation and puncture (CLP) surgery. LPS or CLP surgery induced kidney cell apoptosis increasing. However, the kidney injury indexes of miRNA groups which were transfected with miRNA-21 were significantly suppressed. In further study, the relative proteins expressions were evaluated to explain the miRNA-21 mechanism to improve sepsis induced kidney cell apoptosis...
August 14, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28811951/granulomatosis-with-polyangiitis-presenting-as-pyrexia-of-unknown-origin-leukocytosis-and-microangiopathic-haemolytic-anemia
#2
Sima Terebelo, Iona Chen
A 66-year-old woman presented to the Emergency Department with a florid sepsis-like picture, a two-week history of fever, relative hypotension with end organ ischemia (unexplained liver enzyme and troponin elevations), and nonspecific constitutional symptoms. She was initially found to have a urinary tract infection but, despite appropriate treatment, her fever persisted and her white blood cell count continued to rise. During her hospitalization the patient manifested leukocytosis to 47,000 WBC/μL, ESR 67 mm/hr (normal range 0-42 mm/hr), CRP 17...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#3
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28804538/exendin-4-assisted-adipose-derived-mesenchymal-stem-cell-therapy-protects-renal-function-against-co-existing-acute-kidney-ischemia-reperfusion-injury-and-severe-sepsis-syndrome-in-rat
#4
Pei-Hsun Sung, Hsin-Ju Chiang, Christopher Glenn Wallace, Chih-Chao Yang, Yen-Ta Chen, Kuan-Hung Chen, Chih-Hung Chen, Pei-Lin Shao, Yung-Lung Chen, Sarah Chua, Han-Tan Chai, Yi-Ling Chen, Tien-Hung Huang, Hon-Kan Yip, Mel S Lee
This study tested the hypothesis that combined therapy with exendin-4 (Ex4) and autologous adipose-derived mesenchymal stem cells (ADMSCs) was superior to either alone for protecting renal function against acute kidney ischemia-reperfusion (IR; 40-min ischemia/27-h reperfusion) injury when complicated by sepsis syndrome (SS; by cecal-ligation-puncture). Adult-male Sprague-Dawley rats (n=40) were equally divided into group 1 (sham-control), group 2 (IR-SS), group 3 (IR-SS + Ex4, 10 μg/kg subcutaneously 30 min after reperfusion and daily for 3 days), group 4 [IR-SS + ADMSC (1...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28799580/risk-prediction-of-acute-kidney-injury-by-timp-2-%C3%A2-igfbp7
#5
M Kimmel, M Schanz, M D Alscher
Acute kidney injury (AKI) is a common syndrome with increased mortality, a heavy burden of illness and high cost. The Kidney Disease Improving Global Outcomes (KDIGO) criteria for staging of AKI have been validated in large patient cohorts and classify AKI into three stages. In order to achieve prevention or early therapy, the focus of scientific interest is early detection and risk prediction of AKI. The combination of the two cell cycle arrest markers [TIMP-2]·[IGFBP7] in the urine shows good results in the risk prediction of AKI in different clinical settings (intensive care medicine, sepsis, cardiac surgery, emergency department)...
June 2017: Drugs of Today
https://www.readbyqxmd.com/read/28792165/acute-stylet-peritoneal-dialysis-in-acute-kidney-injury-the-soul-never-dies
#6
Amith Vijay Leon D'Souza, Nishad Raveendran, Rajendra Singh Tanwar, Piyush Kimmatkar, Pankaj Beniwal, Dhananjai Agarwal, Vinay Vinay
BACKGROUND: Acute Kidney Injury (AKI) has a significant mortality rate. In developing countries, mortality due to AKI is high due to lack of access to dialysis facilities and related cost. The main goal of International Society of Nephrology (ISN) 0 by 25 initiative is to eliminate deaths due to AKI. Peritoneal dialysis is an underutilized modality in such a scenario. The aim of this study was to look into effectiveness of starting Acute stylet Peritoneal Dialysis (PD) in a resource constraint settings...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28777197/elabela-improves-cardio-renal-outcome-in-fatal-experimental-septic-shock
#7
David Coquerel, Frédéric Chagnon, Xavier Sainsily, Lauralyne Dumont, Alexandre Murza, Jérôme Côté, Robert Dumaine, Philippe Sarret, Éric Marsault, Dany Salvail, Mannix Auger-Messier, Olivier Lesur
OBJECTIVES: Apelin-13 was recently proposed as an alternative to the recommended β-adrenergic drugs for supporting endotoxin-induced myocardial dysfunction. Since Apelin-13 signals through its receptor (Apelin peptide jejunum) to exert singular inotropic/vasotropic actions and to optimize body fluid balance, this candidate pathway might benefit septic shock management. Whether the newly discovered ELABELA (ELA), a second endogenous ligand of the Apelin peptide jejunum receptor highly expressed in the kidney, further improves cardio-renal impairment remains unknown...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28772171/factors-associated-with-an-increased-risk-of-perioperative-cardiac-arrest-in-emergent-and-elective-craniotomy-and-spine-surgery
#8
Timothy D Quinn, Ethan Y Brovman, Linda S Aglio, Richard D Urman
OBJECTIVE: Cardiac arrest following neurosurgery is a devastating complication associated with significant postoperative morbidity and mortality. There are no published studies that have used a large and robust multicenter database to specifically examine demographic and surgical risk factors associated with cardiac arrests following craniotomy and spine surgeries, respectively. PATIENTS AND METHODS: We retrospectively analyzed data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the period between January 1, 2007 and December 31, 2013, focusing on cardiac arrest associated with craniotomy and spine surgery from the intraoperative period to 30days after surgery...
July 25, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28761227/acute-kidney-injury-in-pregnancy-specific-disorders
#9
REVIEW
J Prakash, V C Ganiger
The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR) are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28761207/importance-of-rifle-risk-injury-failure-loss-and-end-stage-renal-failure-and-akin-acute-kidney-injury-network-in-hemodialysis-initiation-and-intensive-care-unit-mortality
#10
Iskender Kara, Fatma Yildirim, Esra Kayacan, Burcu Bilaloğlu, Melda Turkoglu, Gülbin Aygencel
Our study evaluated the differences between early and late hemodialysis (HD) initiation in the intensive care unit (ICU) according to the RIFLE (Risk, Injury, Failure, Loss, and End-stage renal failure) and AKIN (Acute Kidney Injury Network) classifications. On the assumption that early initiation of HD in critical patients according to the RIFLE and AKIN criteria decreases mortality, we retrospectively evaluated the medical records of 68 patients in our medical ICU and divided the patients into 2 groups: Those undergoing HD in no risk, risk, or injury stage according to RIFLE and in stage 0, I, or II according to AKIN were defined as early HD and those in failure stage according to RIFLE and in stage III according to AKIN were defined as late HD...
July 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28757820/nonconventional-markers-of-sepsis
#11
Péter Kustán, Zoltán Horváth-Szalai, Diána Mühl
Sepsis still remains a challenging healthcare problem with high mortality rate. To improve outcome, early diagnosis and monitoring of sepsis is of utmost importance. In this process objective laboratory parameters are the most helpful. Procalcitonin and C-reactive protein are the most commonly used and recommended markers of sepsis however, more than 200 sepsis biomarkers have already been published. This mini review focuses on nonconventional novel possibilities for the recognition of sepsis severity. Presepsin, actin and actin scavenger proteins (gelsolin and Gc-globulin) and orosomucoid are discussed...
May 2017: EJIFCC
https://www.readbyqxmd.com/read/28757259/endotoxemia-induces-lung-brain-coupling-and-multi-organ-injury-following-cerebral-ischemia-reperfusion
#12
Nguyen Mai, Landa Prifti, Aric Rininger, Hannah Bazarian, Marc W Halterman
Post-ischemic neurodegeneration remains the principal cause of mortality following cardiac resuscitation. Recent studies have implicated gastrointestinal ischemia in the sepsis-like response associated with the post-cardiac arrest syndrome (PCAS). However, the extent to which the resulting low-grade endotoxemia present in up to 86% of resuscitated patients affects cerebral ischemia-reperfusion injury has not been investigated. Here we report that a single injection of low-dose lipopolysaccharide (50μg/kg, IP) delivered after global cerebral ischemia (GCI) induces blood-brain barrier permeability, microglial activation, cortical injury, and functional decline in vivo, compared to ischemia alone...
July 28, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28755257/two-way-interaction-effects-of-perioperative-complications-on-30-day-mortality-in-general-surgery
#13
Minjae Kim, Guohua Li
BACKGROUND: Multiple perioperative complications increase mortality risk, and certain complications synergistically increase this risk to a greater degree than might be expected if the complications were independent, but these effects are not well established. METHODS: This is a retrospective cohort study of 422,827 intraabdominal general surgery patients (American College of Surgeons National Surgical Quality Improvement Program 2005-2011). Eight complications were evaluated: acute respiratory failure (ARF), acute kidney injury (AKI), sepsis/septic shock, stroke, cardiac arrest (CA), myocardial infarction (MI), deep vein thrombosis/pulmonary embolus, and transfusion...
July 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28749627/acute-kidney-injury-in-pediatric-patients-diagnosis-and-management-in-the-emergency-department-digest
#14
Daniel Mohrer, Melissa Langhan, Pradip Chaudhari
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children...
May 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28748892/clinical-profile-of-geriatric-acute-kidney-injury-in-a-tertiary-care-center-from-south-india
#15
Eshwarappa Mahesh, Praveen Nallamuthu, Mahesh Kumar, Parampalli Rakesh Madhyastha, Gurudev Konanna
The incidence of acute kidney injury (AKI) is high in the elderly, who comprise an ever-growing segment of the population. Elderly patients pose a different set of diagnostic and therapeutic challenge owing to their associated comorbidities. AKI in the elderly is associated with an increased risk of mortality, morbidity, prolonged length of stay, and progression to chronic kidney disease. Data regarding the clinical profile of AKI in the elderly from the South Indian population are limited. Hence, we present this analysis of the etiological and prognostic factors associated with AKI in elderly population from South India...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#16
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28727676/association-between-diabetes-mellitus-and-outcomes-of-patients-with-sepsis-a-meta-analysis
#17
Zhiwei Wang, Jianan Ren, Gefei Wang, Qinjie Liu, Kun Guo, Jieshou Li
BACKGROUND Diabetes mellitus (DM) is a critical medical problem that can make people more likely to develop infectious complications, even sepsis. However, the influence of DM on the outcomes of septic patients is still controversial. Thus, we conducted the present meta-analysis to investigate whether DM worsens outcomes of septic patients. MATERIAL AND METHODS We searched studies from PubMed, Embase, and Cochrane Library databases from 1966 to July 1, 2016. The primary outcome we chose was 28-day or 30-day mortality or in-hospital mortality...
July 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28724597/multifocal-septic-arthritis-gluteal-abscess-and-spondylodiscitis-by-streptococcus-dysgalactiae-subspecies-equisimilis-after-an-intramuscular-injection
#18
Rita Marques Pocinho, Liliana Antunes, Pedro Pires, Isabel Baptista
We present the case of a 63-year-old man, admitted for hand cellulitis and acute kidney injury. A Streptococcus dysgalactiae subsp equisimilis (SDSE) was isolated in blood cultures and despite directed intravenous antibiotherapy, the patient evolved unfavourably, with dorsolumbar spondylodiscitis, multifocal septic arthritis and abscesses. CT also showed densification of the gluteal muscles, multiple air bubbles in the psoas, paraspinal muscles and spinal canal that were associated with an intramuscular injection administered 1 week earlier for a backache...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28706580/risk-factors-for-acute-kidney-injury-after-partial-hepatectomy
#19
Luis Cesar Bredt, Luis Alberto Batista Peres
AIM: To identify risk factors for the occurrence of acute kidney injury (AKI) in the postoperative period of partial hepatectomies. METHODS: Retrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified...
June 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28706103/vitamin-d-levels-in-critically-ill-patients-with-acute-kidney-injury-a-protocol-for-a-prospective-cohort-study-vid-aki
#20
Lynda Katherine Cameron, Katie Lei, Samantha Smith, Nanci Leigh Doyle, James F Doyle, Kate Flynn, Nicola Purchase, John Smith, Kathryn Chan, Farida Kamara, Nardos Ghebremedhin Kidane, Lui G Forni, Dominic Harrington, Geeta Hampson, Marlies Ostermann
INTRODUCTION: Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality...
July 12, 2017: BMJ Open
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